Department of Veterans Affairs M21-1, Part III, Subpart iv

Veterans Benefits Administration July 30, 2015

Washington, DC 20420

Transmittal Sheet
Changes Included in This Revision
/ The table below describes the changes included in this revision of Veterans Benefits Manual M21-1, Part III, “General Claims Process,” Subpart iv, “General Rating Process.”
Notes:
·  The term “regional office” (RO) also includes pension management center (PMC), where appropriate.
·  Unless otherwise noted, the term “claims folder” refers to the official, numbered, Department of Veterans Affairs (VA) repository – whether paper or electronic – for all documentation relating to claims that a Veteran and/or his/her survivors file with VA.
·  Minor editorial changes have also been made to
-  reorder and restructure the entire section into a more logical order
-  update incorrect or obsolete references
-  update obsolete terminology, where appropriate
-  renumber each topic based on the standard that the first topic in each section is Topic 1
-  reassign alphabetical designations to individual blocks, where necessary, to account for new and/or deleted blocks within a topic
-  update section and topic titles to more accurately reflect their content
-  clarify block labels and/or block text, and
-  bring the document into conformance with M21-1 standards.
Reason(s) for the Change / Citation
To clarify the policy on using an appropriate examination facility. / M21-1 Part III, Subpart iv, Section 3, Topic 1, Block b (III.iv.3.A.1.b)
·  To update guidance on foreign claims jurisdiction.
·  To consolidate guidance from old Block o on field investigations and examinations. / III.iv.3.A.1.c
To add information about using the Exam Request Routing Assistant (ERRA) tool. / III.iv.3.A.1.d
To separate definitions of general medical, specialty, and specialist exams into their own individual blocks. / III.iv.3.A.1.f-h
To delete blocks from Topic 1 and relocate information about Disability Benefit Questionnaires (DBQs) to new Topic 3 and to III.iv.3.D. / --
To delete outdated guidance on sending copies of insufficient DBQs to Central Office. / --
To relocate guidance on sending the claims folder with an examination request to new Topic 15. / --
To relocate all blocks about Acceptable Clinical Evidence (ACE) examinations to new Topic 4.
To add a new topic providing guidance on exam request tools. / III.iv.3.A.2
To add new topic providing guidance on DBQs. / III.iv.3.A.3
To add new guidance on DBQs and exam cancellations from Compensation Service Bulletin of May 2012. / III.iv.3.A.3.c
To add new topic providing guidance on ACE Examinations. / III.iv.3.A.4
To add a reference for requesting exams in support of claims for individual unemployability (IU) benefits. / III.iv.3.A.5.a
To add a reference for general medical examination DBQs. / III.iv.3.A.5.c
To add guidance on DBQs that require a specialist. / III.iv.3.A.6.d
To incorporate the use of the Exam Request Builder (ERB) tool into the guidance on requesting a medical opinion. / III.iv.3.A.7.b
To delete guidance on requesting a medical opinion for conflicting medical evidence as the same procedure now applies for all medical opinion requests. / --
To update guidance on properly identifying evidence in a medical opinion request by using the ERB tool. / III.iv.3.A.7.c
To clarify that RO employees should identify all evidence, both favorable and unfavorable, when requesting an exam. / III.iv.3.A.7.d
To relocate guidance on examiner’s statements that an opinion would be speculative from old Block g to III.iv.3.D.2. / --
To update instructions to include using the ERB tool for requesting an opinion in a 38 U.S.C. 1151 claim. / III.iv.3.A.7.f
To clarify the policies on independent medical opinions. / III.iv.3.A.7.i
To update the procedures for requesting an aid and attendance and Housebound examination. / III.iv.3.A.8.c
To add a reference for processing Chapter 18 claims. / III.iv.3.A.9.a
·  To clarify the exam policy for IU claims received from incarcerated Veterans based on Fast Letter 11-02.
·  To add references. / III.iv.3.A.9.d
To add guidance on homeless Veteran examination requests. / III.iv.3.A.9.g
To clarify who may conduct a social survey. / III.iv.3.A.10.d
To add references for developing former prisoner of war (FPOW) claims. / III.iv.3.A.11.a
·  To clarify that monetary benefits to an FPOW should not be denied unless the claimant was offered a complete examination.
·  To add a reference to the relevant regulation. / III.iv.3.A.11.b
To note that the FPOW DBQ is restricted to internal VA use and cannot be completed by a contract examiner. / III.iv.3.A.11.c
To update information on FPOW examination requests. / III.iv.3.A.11.d
To delete guidance on when to order reexaminations in FPOW cases as RO employees should follow the guidance on adequacy of examinations (III.iv.3.D) and duty to assist with an examination (I.1.C.3). / --
To delete old Topic 13 which contained guidance on the use of VA Form 21-2507, Request for Physical Examination. This form is no longer in use. / --
To update guidance on who is eligible for pre-discharge examinations. / III.iv.3.A.13.a
To add information about Separation Health Assessment (SHA). / III.iv.3.A.13.b
To add a new Block containing guidance on the SHA and general medical examinations. / III.iv.3.A.13.c
To expand the guidance that was previously for BDD claims and pregnant servicewomen so that it is now relevant to examinations of pregnant claimants. / III.iv.3.A.14
To delete outdated guidance on BDD claims and pregnant servicewomen. / --
To add new topic providing guidance on examiner review of the claims folder. / III.iv.3.A.15
To add new Block consolidating and updating the procedures for requesting an exam. / III.iv.3.A.16.a
To delete and relocate to new Topic 2 Blocks a and b on the ERB and CAPRI. / --
·  To update guidance on entering an exam request in Compensation and Pension Record Interchange (CAPRI).
·  To add discussion of entering the claim type and special considerations. / III.iv.3.A.16.b
To delete outdated information on adding priority of an exam request as this field is no longer available in CAPRI. / --
To relocate guidance on the folder copy of the examination request to Topic 16, Block a. / --
To relocate guidance on requesting examination of claimants residing in the jurisdiction of another regional office to Topic 1. / --
Rescissions
/ None
Authority
/ By Direction of the Under Secretary for Benefits
Signature
/ Thomas J. Murphy, Director
Compensation Service
Distribution
/ LOCAL REPRODUCTION AUTHORIZED

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